Waist-height ratio as an indicator of systemic alterations in obese paediatric patients

Arturo Perea Martínez1, Paul Tadeo Ríos Gallardo1, Lilia Mayrel Santiago Lagunes1, Aranza Lilian
Perea Caballero1, María De los Ángeles Hernández López1, Ariada Guadalupe Lara Campos1
1National Institute of Pediatrics, Clinical Obesity and Non Communicable disease, México, Mexico


Objectives and Study:


To determine the association of systemic alterations with the stratified waist-
height ratio in obese paediatric patients. Descriptive, transversal, observational and retrospective study.




698 individuals between 5 and 18 years old who attended for the Obesity and Adolescents Clinic of the National Institute of Paediatrics (COAINP) with a diagnosis of overweight (Z score of Body Mass Index [BMI] above +1 Standard Deviation [SD] and up to +1.99 DE for age/sex) and obesity (BMI Z score above +2 SD for age/sex) according to international standards without presenting any intercurrent pathology. The waist-height ratio (W/H ratio) was established at different parameters.
Metabolic values were according to National Cholesterol Education Program and Adult Treatment Panel III (NCEP-ATP III), hepatic enzyme values were defined as suggested by the National Health and Nutrition Examination Survey (NHANES), haematological values were according to the criteria of the World Health Organization (WHO) and blood pressure classification was according to The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of the National Institutes of Health (NIH). Software IBM SPSS Statistics V.24.




Metabolic, hepatic and hematological alterations were found in a greater presence in the W/H ratio stratum < 0.49. Metabolic alterations show a prevalence of over 50% in all strata of the W/H ratio. Hepatic alterations are shown above 48% in all strata. In relation to blood disorders and blood pressure, the prevalence is less than 40%. It is noteworthy that the sample size for each stratum generates a bias in the prevalence of risk.





Evidence has shown that W/H ratio is a useful index for evaluating abdominal visceral fat associated with systemic alterations, such as metabolic, hepatic, haematological and blood pressure changes. Several studies have demonstrated a stronger association of W/H ratio with cardiovascular risk factors compared to BMI and waist circumference (WC).

Recent studies demonstrate an association between Non-alcoholic fatty liver disease (NAFLD), blood lipid levels, haematological profile and blood pressure with WC and W/H ratio. It is worth mentioning that the W/H ratio could be a good predictor for metabolic syndrome and Obstructive sleep apnea-hypopnea syndrome (OSAHS).

Sistemic alterations

Contact e-mail address: clinicaadolescentes.inp@hotmail.com